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WOCNs Mission Trips

Darlene Shutt’s Mission Experience

ON A MISSION AGAIN!  For the last three years I have had the opportunity to go to Honduras and Panama as part of a medical mission team member. It has been very rewarding as well as overwhelming.  I went with a small medical group of seven people to very remote areas.  One commented in his Georgia twang, "Lord, you didn't say I needed to go to the end of the world and turn left!  Well that is what we needed in many cases.  It was in this Comayagua, Honduras region in a mountainous village that I cared for a post-operative infected drain sites for a mastectomy wound.  The people did not have the means to reach us, so we traveled to reach them.

Guaymi’s Indian village clinic in PanamaIn the mountains, along remote river areas, in the banana fields, where ever the people were we went. In the Guaymi’s Indian village clinic in Panama we had people walk for hours to come to the clinic, on lady 72 years old walked three hours. 

At first, I was discouraged about the ability to make a real difference in the lives of these people.  I came to understand with opening a door to the possibility that things might be better and by providing education, we could indeed impact the future of this remote area.  There was a family going hungry because the man had such poor eyesight due to cataracts that he could not work. After much planning, months after we left, in late September 2011, he had that surgery and now is on the mend. In Honduras a small infant was identified as having Baller-Gerold Syndrome, which is premature fusion of the skull suture lines.  We took up a collection and were able to get this young mother and her son connected with the right people in their public health care system.

Of course there were some pretty interesting "hut calls" for those that were so sick the family was not able to bring them to us.  We stepped up a cinder block step and chickens came flying out the windows.  There was an open fire and no chimney at all. It just rose up and through the ceramic tiled roof, which is the cheapest thing they have. Most of the time there was no electricity or running water.  No, not even a fan in 100 plus temperatures and the only clean water was the water we brought with us.  We saw on average 130 to 150 patients a day.  

Some of the wounds were from severe machete injuries, abscesses, occasional pressure ulcer or post-surgical wound.  In Panama we were seeing these small erythematous wounds on the children’s feet.  After some research we realized that this was from a certain type of parasite that entered the body through the feet.  I was struck by how fearful people are related to their health due to the lack of public health education.  It was a real awakening to how fortunate we are and how the rest of the world lives every day. 

In the United States it hits the evening news if a child goes to school with a small pin knife, but in Honduras I pictured a young boy about 10 years old going to school with a machete!  The reason, to cut whatever small branches or brush he might come across on his way home so that mom would have something to burn to cook the family dinner.   The children wear uniforms and it cost them $40.00 a year for a child to attend school in a country that a very good wage is $6.00 a day.

We did a hut call for a man who was the only breadwinner in the house. He was a roofer and had fallen off the roof, fracturing several ribs.  The public health care system gave a diagnosis but no follow up and the family did not have the means to get him back to the emergency room or clinic to be treated for his pneumonia.  The stucco house with ceramic tile roof had two rooms and was shared by 7 family members.

Guaymi’s Indian village clinic in PanamaOf course there are homeless, many women and children after all they are considered expendable.  One day we were approached by a mission group that was concerned about a man who lived on the street with many large sores on his legs.  They had tried to get him to go to the hospital but he refused (sound familiar)?  Three of our medical team, the physician, nurse practitioner, and myself, went with this group late one night to see him.  His wounds were typical lower extremities venous stasis ulcers.   He had also developed left arm edema. The physician felt this was most likely a DVT.  The medical team was excited about having a reason to see inside the hospital in Comayagua, Honduras, which was also a teaching hospital. 

The waiting room was populated with the usual late night group.  We were quickly taken back to the triage room which had a curtain, looked like a bed sheet, that separated this area with a desk and a very overwhelmed Intern from the rest of a large room.  I don’t know where the HIPPA policy and risk management where because they offered to take the physician with our group upstairs to the records department so that he could review the chart right then.  While the NP and I stood at the doorway waiting, a man who was in a wheelchair was quickly pushed passed us. Later I found out it was his wife that was pushing him.  He had blood dripping into a towel on his lap; a large flap of tissue was hanging off his forehead, yet another machete accident.  We realized that behind what looked like a bed sheet was an area with a stretcher.  The man was placed on the stretcher, had an IV started and then we saw a bag of IV fluids hung.  There are many real concerns about infection and good wound care.

The spring of 2012 medical mission trip will be going to the Philippines.  I strongly encourage anyone who gets the opportunity to take one of these trips. It is very rewarding and truly humbling.   

Darlene Shutt